Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mrs. Kelly Green Jackson, SLP

Individual provider Speech-Language Pathologist · NPI 1083632467

Mrs. Kelly Green Jackson, SLP is a Speech-Language Pathologist in Lake Park, Georgia. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2006
What do these letters mean?
SLP — Speech-Language Pathologist
Treats speech, language and swallowing disorders.

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Practice location Address checks out

5314 Moss Oak Trl
Lake Park, GA 31636-3300
Phone: (386) 362-8564
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence SA8681 (FL)

Record details

NPI number1083632467
Entity typeIndividual (Type 1)
GenderFemale
Credentials SLP
Sole proprietorYes
NPI enumeratedJuly 17, 2006
Last updated in NPPESJanuary 27, 2025
Certification dateJanuary 27, 2025

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